PEEBLES FAMILY CARE HOME (NPI# 1578749149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578749149 |
| Entity Type | Organization |
| Organization Name | PEEBLES FAMILY CARE HOME |
| Other Organization Name | PALS ASSISTED LIVING SERVICES INC |
| Practice Address |
404 North Broadway Ave Stockton CA 95205 |
| Practice Telephone | 2094643024 |
| Practice Fax Number | 2099445659 |
| Mailing Telephone | 2094643024 |
| Mailing Fax Number | 2099445659 |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2008-01-14 |
| Authorized Official Name | MS. NAWANA MIESA GRAY (ADMINISTRATOR CEO) |
| Authorized Official Telephone | 2092980849 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | CA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| PALS Assisted Living Services Inc | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861726432 | Peebles Family Care Home | Durable Medical Equipment & Medical Supplies | 404 North Broadway Ave, Stockton, CA 95205-4737 | 2009-09-29 |
| Street Address |
404 NORTH BROADWAY AVE |
| City | STOCKTON |
| State | CA |
| Zip Code | 95205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861726432 | Peebles Family Care Home | Durable Medical Equipment & Medical Supplies | 404 North Broadway Ave, Stockton, CA 95205-4737 | 2009-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841801081 | Telegenx, LLC | Durable Medical Equipment & Medical Supplies | 127 S Locust St, Stockton, CA 95205 | 2020-08-12 |
| 1487130191 | Rassiwala Dental Corporation | Dentist | 2043 E Fremont St Ste 8, Stockton, CA 95205 | 2018-07-16 |
| 1518464692 | Szarisse Fernandez | Pharmacist | 2040 E. Mariposa Rd., Stockton, CA 95205 | 2018-04-06 |
| 1467820019 | San Joaquin County Bhs | Non-emergency Medical Transport (VAN) | 1149 N. El Dorado St., Stockton, CA 95205 | 2015-09-11 |
| 1346617651 | Kevin G.y. Tom | Pharmacist | 1528 Fremont St, Stockton, CA 95205 | 2015-08-24 |
| 1780874149 | Mv Transportation | Non-emergency Medical Transport (VAN) | 1250 South Wilson Way, Mv Transportation Ste #a1, Stockton, CA 95205 | 2007-07-31 |
| 1467513549 | Stockton Pharmacy | Pharmacy | 3330 E Main St, Stockton, CA 95205 | 2006-12-13 |
| 1174155170 | Phillip Brandon Long | Pharmacist | 2040 E Mariposa Rd, Stockton, CA 95205 | 2020-02-07 |
| 1558904136 | Angela Moss Burns | Counselor | 430 N Pilgrim St, Stockton, CA 95205 | 2019-10-25 |
| 1730669235 | Katelyn Jeane Wells | Counselor | 430 N Pilgrim St, Stockton, CA 95205 | 2018-08-15 |
| Find all providers in zip 95205 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386833812 | Venus Basto Narvarte | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3510 Windham Cir, Stockton, CA 95209-1137 | 2007-10-22 |
| 1235328337 | Elekarim Residential Care Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1785 Henry Long Blvd, Stockton, CA 95206-6376 | 2007-10-15 |
| 1568679223 | Carcido's Icf 3 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2721 Jimenez Way, Stockton, CA 95209-1774 | 2007-05-16 |
| 1992912513 | Carcido's Icf 5 (j&m) | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1905 Amberwood Ct, Stockton, CA 95207-8812 | 2007-05-16 |
| 1033326798 | Carcido's Icf 2 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1949 Wagner Heights Rd, Stockton, CA 95209-1846 | 2007-05-16 |
| 1447466321 | Carcido's Icf 1 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 8514 Colonial Dr, Stockton, CA 95209-2321 | 2007-05-15 |
| 1063628972 | Carcido's Icf 4 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 8344 Chevalier Way, Stockton, CA 95210-2277 | 2007-05-15 |
| 1932247541 | Marcies Manor IIi Icf | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1528 Venetian Dr, Stockton, CA 95207-5422 | 2007-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538776323 | Calston Manor | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 44661 Calston Ave, Lancaster, CA 93535-3430 | 2020-09-25 |
| 1457966822 | Invincible Villas, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 27539 Glasser Ave, Canyon Country, CA 91351-2039 | 2020-09-12 |
| 1528671633 | Eliaa, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1229 Kelley Avenue, Corona, CA 92882-4207 | 2020-08-28 |
| 1902417090 | Kavere Services Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 531 N Mills Ave, Lodi, CA 95242-2220 | 2020-08-12 |
| 1568071488 | Jnp Residential | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1518 S Wadsworth Ave, Compton, CA 90220-3951 | 2020-07-27 |
| 1043833734 | E&s Jensen Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 9629 Ridgerock Dr, Elk Grove, CA 95624-4461 | 2020-05-28 |
| 1124663588 | The Caring Bunch | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4355 Sepulveda Blvd Apt 125, Sherman Oaks, CA 91403-3911 | 2019-11-08 |
| 1821655507 | Creative Lifestyles Home Care Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1022 W Florence Ave, Los Angeles, CA 90044-2442 | 2019-05-28 |
| 1386160562 | Blueprint Development Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2501 Sycamore Ln, Palmdale, CA 93551-1518 | 2017-08-18 |
| 1427592963 | Carissa Group Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1048 Stowell Ranch Cir, Corona, CA 92881-4739 | 2016-12-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.